**the mental health thread** (1 Viewer)

[Rattle and Hum]

Aren't psychiatrists supposed to be helping out more than that? Or have they just become de facto "doctors of the mind"?

I think they are just medication managers at this point.

 

[Long Ball Larry]

I probably know what the responses will be here, but my relationship with my therapist has gotten kind of stale. I've been going to him for over 9 years now and it's kind of the same thing every session. I like him a lot, it's like going to chat with a good friend for an hour, a friend with a lot of insight and suggestions. But I feel that for $40/hour it should almost be magical. Is it time to cut ties and try and find someone else?

I also feel the same way about my calls with my psychiatrist. I don't even talk to the doctor... just nurse practitioner. She doesn't ask me anything except "how I'm doing with my medications". She refills them and then schedules me for two months out. Boom, $40. Aren't psychiatrists supposed to be helping out more than that? Or have they just become de facto "doctors of the mind"?

What is it that you are trying to get out of therapy at this point? I think you need to answer that for yourself and then that will guide you to your next step. I’m sure you’re different from 9 years ago and maybe the therapist is too. maybe you need to work on something else that they are not pushing you to. Probably the best thing to do is to think about what your goals are now and then talk to your therapist about that and see if it’s still a good fit. Or tell them that you are trying to figure that out and maybe they will either be able to help identify those goals and a path or they won’t be particularly helpful. Either way, that will probably give you your answer about what to do.

 

[Mrs. Rannous]

I probably know what the responses will be here, but my relationship with my therapist has gotten kind of stale. I've been going to him for over 9 years now and it's kind of the same thing every session. I like him a lot, it's like going to chat with a good friend for an hour, a friend with a lot of insight and suggestions. But I feel that for $40/hour it should almost be magical. Is it time to cut ties and try and find someone else?

I also feel the same way about my calls with my psychiatrist. I don't even talk to the doctor... just nurse practitioner. She doesn't ask me anything except "how I'm doing with my medications". She refills them and then schedules me for two months out. Boom, $40. Aren't psychiatrists supposed to be helping out more than that? Or have they just become de facto "doctors of the mind"?

What is it that you are trying to get out of therapy at this point? I think you need to answer that for yourself and then that will guide you to your next step. I’m sure you’re different from 9 years ago and maybe the therapist is too. maybe you need to work on something else that they are not pushing you to. Probably the best thing to do is to think about what your goals are now and then talk to your therapist about that and see if it’s still a good fit. Or tell them that you are trying to figure that out and maybe they will either be able to help identify those goals and a path or they won’t be particularly helpful. Either way, that will probably give you your answer about what to do.

That, or it's working very well for you. You seem to be describing a good result.

 

[BobbyLayne]

Workshopping a short (25 minutes) rock musical with choreography which centers around the theme of A Hero’s Journey.
The opening and closing number is familiar though perhaps not generally associated with war or veterans.

Spoiler

We can be heroes
Just for one day

I, I wish you could swim
Like the dolphins, like dolphins can swim
Though nothing, nothing will keep us together
We can beat them, for ever and ever
Oh we can be Heroes, just for one day

We can be heroes
Just for one day

 

[Joe Bryant]

What is it that you are trying to get out of therapy at this point?

I think that's a great question to ask.

 

[massraider]

Have a good friend who is trying to get some help for one of their kids and they can’t find anybody who comes recommended because they are so booked up - months and months before they can get in to be seen

I was listening to Conan O'Brien podcast, he had Maria Bamford on, she's a really funny person who is really open about her issues.

She was talking about this very thing, and I was blown away. People cannot get an appointment, even people with money to burn

 

[Mrs. Rannous]

Have a good friend who is trying to get some help for one of their kids and they can’t find anybody who comes recommended because they are so booked up - months and months before they can get in to be seen

I was listening to Conan O'Brien podcast, he had Maria Bamford on, she's a really funny person who is really open about her issues.

She was talking about this very thing, and I was blown away. People cannot get an appointment, even people with money to burn

This issue has cropped up on the WaPo advice columns, too. Covid isolation did a number on this stuff.

 

[Ilov80s]

What is it that you are trying to get out of therapy at this point?

I think that's a great question to ask.

It is a great question but also sometimes people don't know and need the therapist to help them find that. Sometimes people feel angry and don't know why or just feel off and can't really pinpoint what it is or how they want to feel.

 

[BobbyLayne]

What is it that you are trying to get out of therapy at this point?

I think that's a great question to ask.

It is a great question but also sometimes people don't know and need the therapist to help them find that. Sometimes people feel angry and don't know why or just feel oit ff and can't really pinpoint what it is or how they want to feel.

I think one thing that is quite helpful is differentiating - and the tricky part, identifying - between thoughts, feelings and emotions.

• emotions start as sensations in the body
• feelings are generated from our thoughts about those emotions

We use the word, "feel," for both physical and emotional states, but I think it can be helpful to recognize we don't have much control over emotions. Oftentimes our emotions are physiological events that hit you without much warning.

Here's what I mean by that. We hear about someone we know who is hospitalized, we may feel sad or we may feel fear. We have an argument with our spouse, and in that moment we might experience anger, disgust, guilt. Our parents or kids give us a gift we were not expecting and we feel surprised or happy. See how I keep using the word "feel"? But what am I describing? It's more about emotions that our body is experiencing.

Feelings on the other than hand are what is generated when we ruminate about those emotions. If the emotion I am feeling is sadness, I might have thoughts that generate feelings of being lonely, vulnerable, despair, hurt.

I don't want to get too far into the weeds or we'll get off track. But understanding what your body is telling you is important. Being cognizant that our feelings come from our thoughts, we may have the epiphany that if I can interrupt my automatic thoughts - that continuous loop tape playing inside everyone's head - then to some degree I can control my feelings. Examine the thought you are having, determine if it's in fact true (it may be) or if in fact it's an irrational conclusion that is reinforcing the negative emotion you are feeling.

They're all interconnected but the key takeaway from what I am trying to say is our emotions just kind of exist. You are going to experience them, and while you can with practice regulate your emotions, the feelings you associate with those emotions are predetermined by the thoughts you are having.

Or as my hometown pastor in West Michigan likes to say, "You do what you do because you feel what you feel because you think what you think."

If you can interrupt that continuous loop tape in your head - by examining and analyzing your thoughts, and when they are false, replacing them with thoughts that are true and rational - then you can dramatically improve your thought patterns and the feelings you feel. In time that will bring your emotions down to a more manageable level.

I hope that helps someone, but if anything I wrote feels unclear please LMK.

 

[Ilov80s]

What is it that you are trying to get out of therapy at this point?

I think that's a great question to ask.

It is a great question but also sometimes people don't know and need the therapist to help them find that. Sometimes people feel angry and don't know why or just feel oit ff and can't really pinpoint what it is or how they want to feel.

I think one thing that is quite helpful is differentiating - and the tricky part, identifying - between thoughts, feelings and emotions.

• emotions start as sensations in the body
• feelings are generated from our thoughts about those emotions

We use the word, "feel," for both physical and emotional states, but I think it can be helpful to recognize we don't have much control over emotions. Oftentimes our emotions are physiological events that hit you without much warning.

Here's what I mean by that. We hear about someone we know who is hospitalized, we may feel sad or we may feel fear. We have an argument with our spouse, and in that moment we might experience anger, disgust, guilt. Our parents or kids give us a gift we were not expecting and we feel surprised or happy. See how I keep using the word "feel"? But what am I describing? It's more about emotions that our body is experiencing.

Feelings on the other than are what is generated when we ruminate about those emotions. If the emotion I am feeling is sadness, I might have thoughts that generate feelings of being lonely, vulnerable, despair, hurt.

I don't want to get too far into the weeds or we'll get off track. But understanding what your body is telling you is important. Being cognizant that our feelings come from our thoughts, we may have the epiphany that if I can interrupt my automatic thoughts - that continuous loop tape playing inside everyone's head - then to some degree I can control my feelings. Examine the thought you are having, determine if it's in fact true (it may be) or if in fact it's an irrational conclusion that is reinforcing the negative emotion you are feeling.

They're all interconnected but the key takeaway from what I am trying to say is our emotions just kind of exist. You are going to experience them, and while you can with practice regulate your emotions, the feelings you associate with those emotions are predetermined by the thoughts you are having.

Or as my hometown pastor in West Michigan likes to say, "You do what you do because you feel what you feel because you think what you think."

If you can interrupt that continuous loop tape in your head - by examining and analyzing your thoughts, and when they are false, replacing them with thoughts that are true and rational - then you can dramatically improve your thought patterns and the feelings will feel. In time that will bring your emotions down to a more manageable level.

I hope that helps someone, but if anything I wrote feels unclear please LMK.

That’s a very helpful way of looking at it, much appreciated.

 

[BobbyLayne]

That’s a very helpful way of looking at it, much appreciated.

<<<************* SME ovah here

*subject matter expert

If you haven't been scoring at home, my full-time job these days is working on my mental illness. As a combat veteran I'm a bit of a walking DSM-5. My acute PTSD causes a few comorbidities. That's a fancy term the medical folks like to use to describe bruh you're really messed up.

My primary mental illness is PTSD, which causes me to have generalized anxiety and sometimes major depression. Other aspects as well but let's not digress too much here. I am thankful I do not have nor have ever experienced major disorders. Lots of my fellow veterans have more severe cases than mine, and schizophrenia or other ****-type mental illnesses may occur. Those require powerful, almost sedative style drugs. I have, through literally thousands of hours of various forms of therapy, learned how to manage my mental illness. This is important to know and affirm if you are experiencing mental illness, and I don't want to gloss over it: you can have a meaningful and productive life while you are managing your mental illness.

@Ilov80s I want to thank you for being non-judgemental and supportive of me over the years. Means more than you know. It has taken a lot of work for me to be strong enough to open up and be comfortable discussing my mental illness.

WRT thoughts, feelings and emotions - I have noted many of the modalities I attend at the VA medical center emphasize the interrelationship of these three things. Simplest way I have heard it said:

What you think directly influences how you feel and how you behave.

So if you think you're a failure, you'll feel like a failure.

Then, you'll act like a failure, which reinforces your belief that you must be a failure.

Hope that is helpful to others. Happy to go deeper if anyone wants to engage about it, but trust me, I know it's not easy being vulnerable with other men.

If you need help, it's OK to say "I need help."

God bless.

 

[AAABatteries]

I probably know what the responses will be here, but my relationship with my therapist has gotten kind of stale. I've been going to him for over 9 years now and it's kind of the same thing every session. I like him a lot, it's like going to chat with a good friend for an hour, a friend with a lot of insight and suggestions. But I feel that for $40/hour it should almost be magical. Is it time to cut ties and try and find someone else?

I also feel the same way about my calls with my psychiatrist. I don't even talk to the doctor... just nurse practitioner. She doesn't ask me anything except "how I'm doing with my medications". She refills them and then schedules me for two months out. Boom, $40. Aren't psychiatrists supposed to be helping out more than that? Or have they just become de facto "doctors of the mind"?

What is it that you are trying to get out of therapy at this point? I think you need to answer that for yourself and then that will guide you to your next step. I’m sure you’re different from 9 years ago and maybe the therapist is too. maybe you need to work on something else that they are not pushing you to. Probably the best thing to do is to think about what your goals are now and then talk to your therapist about that and see if it’s still a good fit. Or tell them that you are trying to figure that out and maybe they will either be able to help identify those goals and a path or they won’t be particularly helpful. Either way, that will probably give you your answer about what to do.

I'm 49 and spent several months seeing a therapist earlier this year. I knew from reading this thread and from talking to others that finding the right therapist is the best first step after you decide to go. Thankfully, the person I found during my first session asked me to reflect on what I wanted to get out of therapy and to bring that back for session 2 to discuss. I thought it was a simple yet very effective way for us to start and it may me feel good about the therapist I chose. So, I second your question and encourage anyone to ask that question.

 

[BobbyLayne]

Also, worth noting I am in one in five.

1 in 5 people experience a mental health crisis during a given calendar year. In America, it’s around 18-27% depending on the data set you are looking l at; that’s in “normal years”, and the post-COVID world has been anything but standard opening procedure.

 

[Ilov80s]

Also, worth noting I am in one in five.

1 in 5 people experience a mental health crisis during a given calendar year. In America, it’s around 18-27% depending on the data set you are looking l at; that’s in “normal years”, and the post-COVID world has been anything but standard opening procedure.

At school we definitely saw an uptick in the 2 years or so “post-COVID”. Things aren’t ideal now but better than they were.

 

[Ilov80s]

@BobbyLayne im curious your thoughts on the “your thoughts influence your feelings”. I’ve heard the opposite before, that how your body feels influences your thoughts. Or the ideas our thoughts originate from feelings in the body. We feel discomfort, it makes us sad, we think negative thoughts. You think it’s the opposite?

 

[BobbyLayne]

@BobbyLayne im curious your thoughts on the “your thoughts influence your feelings”. I’ve heard the opposite before, that how your body feels influences your thoughts. Or the ideas our thoughts originate from feelings in the body. We feel discomfort, it makes us sad, we think negative thoughts. You think it’s the opposite?

Both can be true. in fact, I hope to be able to demonstrate that both are true.

What you are describing is what naturally happens:

• Emotions are a physiological reaction to something. Your body is telling you to feel fear (fight or flight), or sadness, or happiness, etc.
• Feelings reinforce the emotion. If you look at the feelings wheel, emotions are in the center. Each concentrate ring of feelings becomes more specific at the next ring outward.
• Because we are experiencing an emotion and the feelings associated with it, our thoughts become centered upon that. We call these automatic thoughts.

That's what will happen without any intervention on your part.

What I am describing is how to manage your feelings by taking captive of your thoughts. You can't just white knuckle your way into not being angry anymore. Your body needs signals that it's OK to come down from the highly charged state you are in. "Why do they always do that! They're just doing it to make me angry because they don't care" are thoughts that will only serve to fuel your feelings and make you even more angry.

But let's say instead you take captive of your internal thoughts. Do they really always do that? Maybe they only do it 3% of the time, but you always notice. Have you expressed to them how much it frustrates you? Maybe you have been passive and haven't made it known to them you find it annoying. Let's say it's your wife or kids....are they really only doing something (or not doing what they were supposed to) bc they get a kick out of yanking your chain? Perhaps. But it's probable they aren't being mindful. They merely got distracted and forgot. Or they did something (or didn't do something) bc it wasn't a priority for them. They didn't know it was important to you....but did you make it known how much you valued the thing they didn't do or didn't do the way you wanted?

Is this making sense? I feel like I'm drifting into who's on first schtick here. But hopefully you are still following along. By examining our thoughts, and then evaluating if they are true, we can stop those automatic thoughts that fuel the negative feelings. When the feelings subside your emotion will (eventually) change.

I hope I was able to articulate that in a way that was easy to understand.

 

[BobbyLayne]

I probably know what the responses will be here, but my relationship with my therapist has gotten kind of stale. I've been going to him for over 9 years now and it's kind of the same thing every session. I like him a lot, it's like going to chat with a good friend for an hour, a friend with a lot of insight and suggestions. But I feel that for $40/hour it should almost be magical. Is it time to cut ties and try and find someone else?

I also feel the same way about my calls with my psychiatrist. I don't even talk to the doctor... just nurse practitioner. She doesn't ask me anything except "how I'm doing with my medications". She refills them and then schedules me for two months out. Boom, $40. Aren't psychiatrists supposed to be helping out more than that? Or have they just become de facto "doctors of the mind"?

Historically, the psychiatrist I have been assigned has little to nothing to do with my treatment. I think of them as the drug dealer I meet once a quarter.

However, I got a new one in August and I love her personality. She is lively and engaging, a good listener, and is empathetic. I'm looking forward to meeting her in person next month (first session was virtual) - have never felt that about a psychiatrist before.

 

[BobbyLayne]

1:1 that posted about Sep 4? If so, has that improved?

Yes, I'm still training the psychiatry intern who we have; she will be switching her first name to doctor next year. She is perfectly competent, but it's just not a good fit. I have had some effective sessions but essentially I just don't connect with her. I've been very frank with her and explained to her the monotone voice (does. not. vary. pitch. and. pace.) is not helpful, and while she may possess empathy, she doesn't convey it. Fish eyes. I have had a few therapists and have talked about this with quite a few veterans. For a therapist to be effective, the clinician also has to exhibit vulnerability. There is a trust building process. Man, if I'm not getting anything from you, I don't feel like I'm going to be able to open up and go deep bc you are not invested.

I've given it a fair shake through 4-5 sessions but it's not working. I will likely request a change next week. Our program director is a mensch, he was super helpful on Friday and followed up with phone calls and emails to make sure I got the help I needed from the ER psychiatrist. The staff at the VA - at least in the program I utilize - man alive, they aren't just punching in and punching out. They are invested in the veterans and collectively the program functions very much like a surrogate family.

FTR I'm the dad.

• "Omar, put your phone away, please be present for your fellow veterans."
• "Paul, it's OK if you're 5 minutes late, I know you walk slow with two bad knees, but just come in quiet and sit down. The etiquette here is to not interrupt or greet your friends. You don't know what was being said, someone is in pain and they don't need you breaking that up OK pard?"
• "Liba - that's inappropriate. We have female staff and female veterans, that's not the world anymore. I don't care, you need to zip it or step outside but you can't say things like that, OK brother?"

I might do stand up after I graduate the program, the material is almost limitless.

edit word

Sucks about your therapist. I would like to think it's something they can grow into as they evolve in their career but part of me fears it's just their nature and it's how they will always be. Maybe some people respond better to that but I am totally with you, I would absolutely hate talking to someone who is so blank. I am not a therapist per se but I certainly do quite a bit of therapy in my career and there is a time and place for that kind of robotic approach, I don't think it's how you generally build a long term positive relationship. Like you said, the best way to gain someone's trust is to trust them, the best way to get someone to be vulnerable is to vulnerable with them. I know this isn't totally true but I think it's maybe partially true that it doesn't matter what kind of fancy psychology and methods someone knows, what really helps people is having someone they trust and respect who hears them out, makes them feel seen , is able to get deep with them and tells them the hard things that maybe other people aren't willing to say. I know there are definite strategies and approaches that work better for certain mental health concerns but you are totally right that in the end it's ultimately about the relationship.

Connection is crucial. What that means though is different for each veteran. It's more art than science when it comes to treatment sometimes.

On our program's staff we have a diverse set of personalities. I've learned that is by design; different personalities mesh well with different types of therapists. We have one woman who has a nursing background who helps us with nutrition and understanding our prescriptions and the sort of mechanical aspects of managing your mental health. She loves the sound of her own voice; she expects short or monosyllabic answers from the veterans bc she wants to explore every aspect and nuance of the topic she is lecturing on. I could never work with her (she is my neighbor and we see her walking her dog, charming person, my wife loves her, but just wouldn't be a fit.) But some of the veterans respond very well to her. She has a matronly way and some of the guys will bring in their wives to their 1-on-1 session to help the spouse out. Another peer counselor we have is a female veteran and former Army Master Sergeant. She bosses people and orders them what they need to be doing if they plan on getting better. Again, bad fit for me. But for veterans who are somewhat passive and have gone through life respecting authority and following orders, she is perfect.

Yeah, I see the same thing in teaching. There are of course some teachers every kid loves and some every kid hates but for the most part it's mixed. There are teachers who are some kids just adore and then another group of kids despise and it's just that odd connection of personalities that makes or breaks things for people.

I think I am going to talk to my program director at the VA next week about switching therapists. Just getting worse.

This week I observed a couple of troubling things. She makes Veterans feel small with her non-verbals. Like if we're going through a handout and people need time to talk, she wants to keep it moving. Like it's one thing to say gently "@Ilov80s That must have been really difficult for you. You should talk to your one-on-one about it bc that's really hard. So I'm going to pause you there so we can keep on track to get through this." Like a couple of times people in group therapy started to talk and she visibly slumped in her chair and titled her head to the side. She didn't cluck her tongue but I wasn't the only one to notice. I've also seen her interrupt veterans. Now, sometimes that is necessary - like if anyone says something sexist or misogynist, full stop. If someone isn't talking about how something or someone made them feel and they are just telling stories for the laughs, good time to redirect. But to just interrupt when someone is mid-sentence and they're not being disruptive....IDK, man, like I said, others have noticed it too.

Yesterday she canceled our in person bc she had a doctor's appt. No problem, I rescheduled (which caused me to miss a module I never miss.) We had technically difficulties that I don't think were on my end (she has had issues hosting groups remotely in the past.) Ending up using the video app + a phone call for the audio as a workaround, took 15 minutes (and she ended the seseion at 9:45 instead of 9:50 - 30 minutes instead of 50.) I was recounting to her what had happened to me last week, how I was diagnosed as hypo manic bc of a reaction to my antidepressant Rx, et al. She was not involved in any way (which says a lot - normal S.O.P. is to coordinate visits to the ER pysch clinic through your one-on-one but if you feel more comfortable you can reach out to the program director.) I'm about halfway through and she says "yeah, you talked about that in groups this week. What I'd like to know more about is what are you doing to prepare for your trip to Baltimore. You're going to be traveling, meeting up with your wife's friends, in large crowds.....how do you feel about it?"

In the moment I just adjusted on the fly and we discussed that. But later I was like WTAF did she interrupt me to say she wanted to talk about something more important? Like I understand repeating your statements back to you, mirroring, gentle prompts. But "naw I've already heard this one how about we go here instead?"

Pretty sure my Program Director will give me the green light. Might take a week or two to move caseloads around, our full-time staff supports other programs besids the PRRC. But I just don't think it's a healthy choice to keep putting up with her lack of empathy and compassion.

 

[Ilov80s]

1:1 that posted about Sep 4? If so, has that improved?

Yes, I'm still training the psychiatry intern who we have; she will be switching her first name to doctor next year. She is perfectly competent, but it's just not a good fit. I have had some effective sessions but essentially I just don't connect with her. I've been very frank with her and explained to her the monotone voice (does. not. vary. pitch. and. pace.) is not helpful, and while she may possess empathy, she doesn't convey it. Fish eyes. I have had a few therapists and have talked about this with quite a few veterans. For a therapist to be effective, the clinician also has to exhibit vulnerability. There is a trust building process. Man, if I'm not getting anything from you, I don't feel like I'm going to be able to open up and go deep bc you are not invested.

I've given it a fair shake through 4-5 sessions but it's not working. I will likely request a change next week. Our program director is a mensch, he was super helpful on Friday and followed up with phone calls and emails to make sure I got the help I needed from the ER psychiatrist. The staff at the VA - at least in the program I utilize - man alive, they aren't just punching in and punching out. They are invested in the veterans and collectively the program functions very much like a surrogate family.

FTR I'm the dad.

• "Omar, put your phone away, please be present for your fellow veterans."
• "Paul, it's OK if you're 5 minutes late, I know you walk slow with two bad knees, but just come in quiet and sit down. The etiquette here is to not interrupt or greet your friends. You don't know what was being said, someone is in pain and they don't need you breaking that up OK pard?"
• "Liba - that's inappropriate. We have female staff and female veterans, that's not the world anymore. I don't care, you need to zip it or step outside but you can't say things like that, OK brother?"

I might do stand up after I graduate the program, the material is almost limitless.

edit word

Sucks about your therapist. I would like to think it's something they can grow into as they evolve in their career but part of me fears it's just their nature and it's how they will always be. Maybe some people respond better to that but I am totally with you, I would absolutely hate talking to someone who is so blank. I am not a therapist per se but I certainly do quite a bit of therapy in my career and there is a time and place for that kind of robotic approach, I don't think it's how you generally build a long term positive relationship. Like you said, the best way to gain someone's trust is to trust them, the best way to get someone to be vulnerable is to vulnerable with them. I know this isn't totally true but I think it's maybe partially true that it doesn't matter what kind of fancy psychology and methods someone knows, what really helps people is having someone they trust and respect who hears them out, makes them feel seen , is able to get deep with them and tells them the hard things that maybe other people aren't willing to say. I know there are definite strategies and approaches that work better for certain mental health concerns but you are totally right that in the end it's ultimately about the relationship.

Connection is crucial. What that means though is different for each veteran. It's more art than science when it comes to treatment sometimes.

On our program's staff we have a diverse set of personalities. I've learned that is by design; different personalities mesh well with different types of therapists. We have one woman who has a nursing background who helps us with nutrition and understanding our prescriptions and the sort of mechanical aspects of managing your mental health. She loves the sound of her own voice; she expects short or monosyllabic answers from the veterans bc she wants to explore every aspect and nuance of the topic she is lecturing on. I could never work with her (she is my neighbor and we see her walking her dog, charming person, my wife loves her, but just wouldn't be a fit.) But some of the veterans respond very well to her. She has a matronly way and some of the guys will bring in their wives to their 1-on-1 session to help the spouse out. Another peer counselor we have is a female veteran and former Army Master Sergeant. She bosses people and orders them what they need to be doing if they plan on getting better. Again, bad fit for me. But for veterans who are somewhat passive and have gone through life respecting authority and following orders, she is perfect.

Yeah, I see the same thing in teaching. There are of course some teachers every kid loves and some every kid hates but for the most part it's mixed. There are teachers who are some kids just adore and then another group of kids despise and it's just that odd connection of personalities that makes or breaks things for people.

I think I am going to talk to my program director at the VA next week about switching therapists. Just getting worse.

This week I observed a couple of troubling things. She makes Veterans feel small with her non-verbals. Like if we're going through a handout and people need time to talk, she wants to keep it moving. Like it's one thing to say gently "@Ilov80s That must have been really difficult for you. You should talk to your one-on-one about it bc that's really hard. So I'm going to pause you there so we can keep on track to get through this." Like a couple of times people in group therapy started to talk and she visibly slumped in her chair and titled her head to the side. She didn't cluck her tongue but I wasn't the only one to notice. I've also seen her interrupt veterans. Now, sometimes that is necessary - like if anyone says something sexist or misogynist, full stop. If someone isn't talking about how something or someone made them feel and they are just telling stories for the laughs, good time to redirect. But to just interrupt when someone is mid-sentence and they're not being disruptive....IDK, man, like I said, others have noticed it too.

Yesterday she canceled our in person bc she had a doctor's appt. No problem, I rescheduled (which caused me to miss a module I never miss.) We had technically difficulties that I don't think were on my end (she has had issues hosting groups remotely in the past.) Ending up using the video app + a phone call for the audio as a workaround, took 15 minutes (and she ended the seseion at 9:45 instead of 9:50 - 30 minutes instead of 50.) I was recounting to her what had happened to me last week, how I was diagnosed as hypo manic bc of a reaction to my antidepressant Rx, et al. She was not involved in any way (which says a lot - normal S.O.P. is to coordinate visits to the ER pysch clinic through your one-on-one but if you feel more comfortable you can reach out to the program director.) I'm about halfway through and she says "yeah, you talked about that in groups this week. What I'd like to know more about is what are you doing to prepare for your trip to Baltimore. You're going to be traveling, meeting up with your wife's friends, in large crowds.....how do you feel about it?"

In the moment I just adjusted on the fly and we discussed that. But later I was like WTAF did she interrupt me to say she wanted to talk about something more important? Like I understand repeating your statements back to you, mirroring, gentle prompts. But "naw I've already heard this one how about we go here instead?"

Pretty sure my Program Director will give me the green light. Might take a week or two to move caseloads around, our full-time staff supports other programs besids the PRRC. But I just don't think it's a healthy choice to keep putting up with her lack of empathy and compassion.

Sounds like her social skills aren't so good. Perhaps vets aren't the right setting for her. I think it's the right move requesting a change. You know the relationship isn't working so why waste time or just become more annoyed?

 

[Ilov80s]

So @BobbyLayne I appreciate you referring to the connection between feelings-emotions-thoughts. The teen I am working with, she's definitely bothered quite regularly by unpleasant feelings-emotions-thoughts. She's almost certaily dealing with some level of complex ptsd. Her ace score would be super high. So far, we've knocked out the cutting and drinking. She's attending school regularly and has all As and Bs now so on the outside things look wonderful. She says she doesn't always feel the change though. She's still a little uncomfortable with the idea that she is successful because she doesn't believe she deserves success. We are working on 2 big things now:

1. Anger problem
She is way too passive. Bottles things up, goes along with others even when she doesn't want to and then rages out in situations where it's totally uncalled for and against people that often don't deserve it. She said she feels mad a lot and usually can't figure out why.

2. Anxiety
She has this general feeling that things will go wrong, like everything is just about to turn bad. This also seems to maybe have some connection to stomach problems. She barely eats and says it hurts her stomach when she eats almost anything. However, she also said that when she has anxiety, she feels it in her stomach. I've noted some correlation between her worrying and complaining her stomach hurts more. I do think the physical discomfort is probably connected to her mental health.

We are working on logging when she has unpleasant emotions and logging where she feels them in her body. The goal is try and trace those back to when she first started to feel them and recognize where they came from so she can "give them back" to the people who "gave them to her".

We are also working on some new mantras to replace her old ones. One that has organically come up a few times is that when things have gotten bad for her, really good things have come out of it. So I think we are starting to make some progress on using words to help calm her and replace her negative thoughts. It's a start but I am very optimistic she's going to get there.

 

[BobbyLayne]

So @BobbyLayne I appreciate you referring to the connection between feelings-emotions-thoughts. The teen I am working with, she's definitely bothered quite regularly by unpleasant feelings-emotions-thoughts. She's almost certaily dealing with some level of complex ptsd. Her ace score would be super high. So far, we've knocked out the cutting and drinking. She's attending school regularly and has all As and Bs now so on the outside things look wonderful. She says she doesn't always feel the change though. She's still a little uncomfortable with the idea that she is successful because she doesn't believe she deserves success. We are working on 2 big things now:

1. Anger problem
She is way too passive. Bottles things up, goes along with others even when she doesn't want to and then rages out in situations where it's totally uncalled for and against people that often don't deserve it. She said she feels mad a lot and usually can't figure out why.

2. Anxiety
She has this general feeling that things will go wrong, like everything is just about to turn bad. This also seems to maybe have some connection to stomach problems. She barely eats and says it hurts her stomach when she eats almost anything. However, she also said that when she has anxiety, she feels it in her stomach. I've noted some correlation between her worrying and complaining her stomach hurts more. I do think the physical discomfort is probably connected to her mental health.

We are working on logging when she has unpleasant emotions and logging where she feels them in her body. The goal is try and trace those back to when she first started to feel them and recognize where they came from so she can "give them back" to the people who "gave them to her".

We are also working on some new mantras to replace her old ones. One that has organically come up a few times is that when things have gotten bad for her, really good things have come out of it. So I think we are starting to make some progress on using words to help calm her and replace her negative thoughts. It's a start but I am very optimistic she's going to get there.

That's awesome, brother man.

Take a look at this free guide. I don't think pages 1-3 are applicable to her situation, but there is section on Passive - Assertive - Aggressive communication style pages 4-7. I think you might find the Assertive Rights on page 7 helpful.

Pages 8-10 cover self-esteem. Maybe you could show her the affirmations on page 10 to see if those resonate.

Not a fan of page 11 but the Self-Care on page 12 might be helpful.

Page 13 is useful but only if you are already discussing mindfulness and using breathing techniques as one of her self-management tools. May be N/A.

Good luck. Will be praying for her.

 

[Ilov80s]

So @BobbyLayne I appreciate you referring to the connection between feelings-emotions-thoughts. The teen I am working with, she's definitely bothered quite regularly by unpleasant feelings-emotions-thoughts. She's almost certaily dealing with some level of complex ptsd. Her ace score would be super high. So far, we've knocked out the cutting and drinking. She's attending school regularly and has all As and Bs now so on the outside things look wonderful. She says she doesn't always feel the change though. She's still a little uncomfortable with the idea that she is successful because she doesn't believe she deserves success. We are working on 2 big things now:

1. Anger problem
She is way too passive. Bottles things up, goes along with others even when she doesn't want to and then rages out in situations where it's totally uncalled for and against people that often don't deserve it. She said she feels mad a lot and usually can't figure out why.

2. Anxiety
She has this general feeling that things will go wrong, like everything is just about to turn bad. This also seems to maybe have some connection to stomach problems. She barely eats and says it hurts her stomach when she eats almost anything. However, she also said that when she has anxiety, she feels it in her stomach. I've noted some correlation between her worrying and complaining her stomach hurts more. I do think the physical discomfort is probably connected to her mental health.

We are working on logging when she has unpleasant emotions and logging where she feels them in her body. The goal is try and trace those back to when she first started to feel them and recognize where they came from so she can "give them back" to the people who "gave them to her".

We are also working on some new mantras to replace her old ones. One that has organically come up a few times is that when things have gotten bad for her, really good things have come out of it. So I think we are starting to make some progress on using words to help calm her and replace her negative thoughts. It's a start but I am very optimistic she's going to get there.

That's awesome, brother man.

Take a look at this free guide. I don't think pages 1-3 are applicable to her situation, but there is section on Passive - Assertive - Aggressive communication style pages 4-7. I think you might find the Assertive Rights on page 7 helpful.

Pages 8-10 cover self-esteem. Maybe you could show her the affirmations on page 10 to see if those resonate.

Not a fan of page 11 but the Self-Care on page 12 might be helpful.

Page 13 is useful but only if you are already discussing mindfulness and using breathing techniques as one of her self-management tools. May be N/A.

Good luck. Will be praying for her.

I appreciate the resources. Where we are now from where she in February is truly mind blowing. We refer to as a miracle. She was totally ready to give up on herself and either take her life or just run away and see what life on the streets would be like. As a 14 year old girl with substance issues and a history of being abused, it's pretty obvious where that would have led. I wanted to help but like had no idea this much could change this fast. At this point, we are basically bonded for life. It's like those funny videos you see on the internet where a baby duck befriends a dog and then they are just inseparable despite it making no real sense.

Obviously all these techniques and strategies are really important but I also think caring positive relationships (which come in so many forms) matter more than anything. For me that would include my therapist. If it doesn't feel like they really care, I don't think I would buy into anything they have to say.

 

[BobbyLayne]

Obviously all these techniques and strategies are really important but I also think caring positive relationships (which come in so many forms) matter more than anything.

100%

Especially working with adolescents.

But adults need that as well. The biggest reason I want to dump my therapist is I don’t think she’s all in. I get no feedback from her, expressionless face, none of the social queues someone is actively listening. There’s an undercurrent of arrogance (which may in fact just be her own insecurity), but it’s not my job to manage her.

I am fully empowered to manage my own mental health and I deserve better.

 

[Ilov80s]

Obviously all these techniques and strategies are really important but I also think caring positive relationships (which come in so many forms) matter more than anything.

100%

Especially working with adolescents.

But adults need that as well. The biggest reason I want to dump my therapist is I don’t think she’s all in. I get no feedback from her, expressionless face, none of the social queues someone is actively listening. There’s an undercurrent of arrogance (which may in fact just be her own insecurity), but it’s not my job to manage her.

I am fully empowered to manage my own mental health and I deserve better.

100% competence and knowledge and skillset are all good but connection is everything. The level of crossover between teaching and therapy is interesting.

 

[BobbyLayne]

I think I am going to talk to my program director at the VA next week about switching therapists. Just getting worse.

My new therapist is incredible. Thank God.

Today we concluded our 8-week theater troupe modality (with the awkward acronym VIA PATH - Veterans in Action: Performing Arts for Therapeutic Healing.)

Super fun. Basically put together 10 vignettes of spoken word, interpretive dance, and 3 veterans performed songs. My contribution was a poem I wrote, a choreographed piece with two other veterans set to David Bowie’s “Heroes” (2017 remix version), and functioning as the program narrator. Great turnout, crowd was around 180 for each performance. Immodestly I’d judge we killed it.

Aside - had no idea but a bunch of VA big wigs and a couple pols turned up. They were blown away which likely bodes well for future funding.

Still struggling with hypo mania (medically induced condition that should subside); it’s been 27 days with no change so changed up the cocktail mix. Will assess in two weeks.

Very frustrating. I didn’t opt into the program to get worse lol. I kind of understand now why people throw their pills away and conclude they’re treatment resistant. I’m not that exasperated yet but I have more empathy for anyone who has had something similar happen.

 

[Ilov80s]

I think I am going to talk to my program director at the VA next week about switching therapists. Just getting worse.

My new therapist is incredible. Thank God.

Today we concluded our 8-week theater troupe modality (with the awkward acronym VIA PATH - Veterans in Action: Performing Arts for Therapeutic Healing.)

Super fun. Basically put together 10 vignettes of spoken word, interpretive dance, and 3 veterans performed songs. My contribution was a poem I wrote, a choreographed piece with two other veterans set to David Bowie’s “Heroes” (2017 remix version), and functioning as the program narrator. Great turnout, crowd was around 180 for each performance. Immodestly I’d judge we killed it.

Aside - had no idea but a bunch of VA big wigs and a couple pols turned up. They were blown away which likely bodes well for future funding.

Still struggling with hypo mania (medically induced condition that should subside); it’s been 27 days with no change so changed up the cocktail mix. Will assess in two weeks.

Very frustrating. I didn’t opt into the program to get worse lol. I kind of understand now why people throw their pills away and conclude they’re treatment resistant. I’m not that exasperated yet but I have more empathy for anyone who has had something similar happen.

Congratulations on finally getting a therapist that works for you, is respectful, etc. Sorry to hear though that it hasn't yet netted the results you want. Hopefully with patience there will be progress. I know your persistence is the right way to tackle something like this.

 

[Mrs. Rannous]

with the awkward acronym VIA PATH

Because they desperately needed it to spell "SHIELD".

Or UNCLE. CHAOS. SMERSH.

Who comes up with this stuff?

 

[mr. furley]

anybody here using a light therapy lamp for S.A.D. in winter?

thoughts? recommendations?

 

[Rattle and Hum]

anybody here using a light therapy lamp for S.A.D. in winter?

thoughts? recommendations?

Tried it a few years back. Was meh for me but, looking no back I was probably too depressed for what it could offer help with. Give it a shot... You could probably score one for $20 on FB Marketplace if in a decently populated area. GL

 

[BobbyLayne]

I think I am going to talk to my program director at the VA next week about switching therapists. Just getting worse.

My new therapist is incredible. Thank God.

Today we concluded our 8-week theater troupe modality (with the awkward acronym VIA PATH - Veterans in Action: Performing Arts for Therapeutic Healing.)

Super fun. Basically put together 10 vignettes of spoken word, interpretive dance, and 3 veterans performed songs. My contribution was a poem I wrote, a choreographed piece with two other veterans set to David Bowie’s “Heroes” (2017 remix version), and functioning as the program narrator. Great turnout, crowd was around 180 for each performance. Immodestly I’d judge we killed it.

Aside - had no idea but a bunch of VA big wigs and a couple pols turned up. They were blown away which likely bodes well for future funding.

Still struggling with hypo mania (medically induced condition that should subside); it’s been 27 days with no change so changed up the cocktail mix. Will assess in two weeks.

Very frustrating. I didn’t opt into the program to get worse lol. I kind of understand now why people throw their pills away and conclude they’re treatment resistant. I’m not that exasperated yet but I have more empathy for anyone who has had something similar happen.

Congratulations on finally getting a therapist that works for you, is respectful, etc. Sorry to hear though that it hasn't yet netted the results you want. Hopefully with patience there will be progress. I know your persistence is the right way to tackle something like this.

Just wanted to follow up about my new(ish) therapist. My week starts with a 50 minute session at 9 a.m. on Mondays, and today was.....the best session I've ever had.

Since I began treatment through the VA in October 2019, I have cycled through 3-4 psychiatrists. They're the drug dealers, not really involved other than short sessions once a month to discuss my Rx. But I've got a great one now, she's published a lot of papers in the last decade and I lover her personality - actually look forward to meeting with her. I've also had 6 one-one-one therapists for weekly hourlong sessions. #1-5 were OK, meh, better, much better, and back to meh. The one I have rn is the best.

The lady I am working with is just pitch perfect for me. From another post upthread (Oct 20), my critique of counselor #5:

I was recounting to her what had happened to me last week, how I was diagnosed as hypo manic bc of a reaction to my antidepressant Rx, et al. She was not involved in any way (which says a lot - normal S.O.P. is to coordinate visits to the ER pysch clinic through your one-on-one but if you feel more comfortable you can reach out to the program director.) I'm about halfway through and she says "yeah, you talked about that in groups this week. What I'd like to know more about is what are you doing to prepare for your trip to Baltimore. You're going to be traveling, meeting up with your wife's friends, in large crowds.....how do you feel about it?"

In the moment I just adjusted on the fly and we discussed that. But later I was like WTAF did she interrupt me to say she wanted to talk about something more important? Like I understand repeating your statements back to you, mirroring, gentle prompts. But "naw I've already heard this one how about we go here instead?"

In stark contrast, the gal I meet with now never interrupts me. She might occasionally pause me to check in with how I am feeling in the moment as we discuss a traumatic event. Or she ask if something from the DSM-5 is applicable (she'll haul out her copy and have me read a section.) It's incredibly empowering.

She has helped me understand why critical moments shaped so much of what has happened to me. I am finally in a place where I feel like I understand why I am the way I am. I've been so focused on trying to manage PTSD and depression day to day, using a plethora of tools I've acquired in the last 4-5 years, but it's like triage work. It helps in the moment and I can survive, but we've never gone deeper to understand the underlying issues that drive it and keep it replaying over and over and over.

I'm never going to be cured; that's not a realistic outcome. But I am finally starting to make tangible progress. The single biggest factor has been finding a therapist who was a great fit for me. I don't even feel like I'm in therapy. Told my wife tonight it's like I get to sit down with a really good friend I can trust, they are whip smart, and they're teaching me how to understand what is going on in my body and my mind. I never imagined I would find a counselor who was so invested, talented, and highly skilled.

Super grateful.

Also, if anyone is still reading, and you are not happy with your therapist or the results you are (not) seeing, I encourage you to switch to another one. Eventually you'll find someone who is the right fit for you.

Keep doing the work. You are worth it.

Spoiler: skip if you're a tl;dr kind of person

Today I shared with her a couple of combat incidents that happened while I was in the military. I've talked about that with other psychologists, but it's almost like a sanitized, mythological version. As in....

Event X happened, if I didn't respond then Y and Z were minutes away, without thinking (bc 100s of hours of training the training kicked in), I did my job, meaning ___ people who were trying to kill us died first; later that day I saw unimaginable horror, and boy has that been a mother****er to carry around for 38 years.

Today, for the first time ever, I talked about how I felt in the hours, days and years afterward - I admitted for the first time how (on some level) exhilarating it had been. Not when it was happening, but when I had time to decompress and piece together what we did. I've been able to recall things I had repressed - how guilty I felt bc guys with newer, better equipment than the gear we had got beat by a missile and their shipmates died - and I literally stumbled onto what was happening. Our gear required manual searching and analysis with analog electronics, the newer systems did all that automatically with a computer.* I've had so much survivors guilt over that, it haunts me with intrusive thoughts all the time, the nightmares and waking up in a panic are the worst.

*combat is the most random thing ever when it comes to who gets hit and who makes out; systems & training go a long way but the outcome is still pure luck

We've also been able to link childhood traumatic events and the cumulative effect of not dealing with that caused these symptoms to spill over into the rest of my life. I was so good at compartmentalization and staying on task for decades. Just pushing things further down. For the last 7-8 years I have intrusive thoughts about so many things - seemingly small events that happened 20, 35, even 50+ years ago - it is just ****ing relentless. I have been in incredibly dark places, and felt such despair it would never get better. The net result being I was experiencing anhedonia and battling suicidal ideation.

Now I feel like, maybe, it could get better at some point. That woman is a freaking superhero.

 

[PIK95]

A couple of days ago I was REALLY down in the dumps. Sunday night until Tuesday morning. I'm not gonna say I was suicidal oelr close, but wow I was a mess. Didn't feel good about anything, and even crossed the line into didnt CARE about anything. Funny thing is I snapped out of it almost as fast as I fell into it. It's pretty scary for me feeling that helpless.

Feel decent today. Music usually helps me go from decent mood to great. Unfortunately nothing helps when Im bad. Right now I'm spinning Eat a Peach on my 8080 and it sounds so good. The house is shaking. Another cold rainy day. I went back to Keto in February, and Im down like 20 pounds since. Hoping that's gonna help me feel better. Anyway, hope all you depressers are doing OK today.

 

[nirad3]

Hey y'all - May is Mental Health Awareness Month.

Be kind to one another as you may not know what someone may be struggling with internally.

Text or call 988 if you need to speak to a mental health specialist.

 

[nirad3]

Sigh. Just got back from what may be my last appointment with the therapist I've been seeing monthly (sometimes bi-monthly) for the past decade. He is moving to a "no insurance" model as of June and the cash fee is $200 a pop (versus my $20 co-pay). Ouch. I don't know what to do. Can't afford $200/mo. or even $200 every other month. Just not in the budget.

 

[PIK95]

Sigh. Just got back from what may be my last appointment with the therapist I've been seeing monthly (sometimes bi-monthly) for the past decade. He is moving to a "no insurance" model as of June and the cash fee is $200 a pop (versus my $20 co-pay). Ouch. I don't know what to do. Can't afford $200/mo. or even $200 every other month. Just not in the budget.

My daughter's doc did the same thing. Insurance companies are the devil.

I really wish we got that public option choice back in the day.

 

[Major]

Sigh. Just got back from what may be my last appointment with the therapist I've been seeing monthly (sometimes bi-monthly) for the past decade. He is moving to a "no insurance" model as of June and the cash fee is $200 a pop (versus my $20 co-pay). Ouch. I don't know what to do. Can't afford $200/mo. or even $200 every other month. Just not in the budget.

Sorry to hear that especially after 10 years. I hate that feeling of bouncing around between different folks. Good news is that there are lots of good therapists out there and many that will take your insurance. Hope you find someone that works of you.